Abstract
Study Objective: This systematic review aims to investigate the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD). Methods: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apneahypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST < 90), and minimum and mean oxygen saturation (O2) on DKD were examined. Results: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST < 90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations. Conclusions: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.
| Original language | English |
|---|---|
| Pages (from-to) | 301-308 |
| Number of pages | 8 |
| Journal | Sleep |
| Volume | 39 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Feb 2016 |
| Externally published | Yes |
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Keywords
- Airway
- Albuminuria
- Apnea
- Creatinine
- Diabetes mellitus
- Glomerular filtration rate
- Nephropathy
- Nocturnal hypoxemia
ASJC Scopus subject areas
- Clinical Neurology
- Physiology (medical)
Cite this
The Association between obstructive sleep apnea on diabetic kidney disease : A systematic review and meta-analysis. / Leong, Wen Bun; Jadhakhan, Ferozkhan; Taheri, Shahrad; Thomas, G. Neil; Adab, Peymané.
In: Sleep, Vol. 39, No. 2, 01.02.2016, p. 301-308.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Association between obstructive sleep apnea on diabetic kidney disease
T2 - A systematic review and meta-analysis
AU - Leong, Wen Bun
AU - Jadhakhan, Ferozkhan
AU - Taheri, Shahrad
AU - Thomas, G. Neil
AU - Adab, Peymané
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Study Objective: This systematic review aims to investigate the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD). Methods: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apneahypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST < 90), and minimum and mean oxygen saturation (O2) on DKD were examined. Results: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST < 90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations. Conclusions: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.
AB - Study Objective: This systematic review aims to investigate the association between obstructive sleep apnea (OSA) and diabetic kidney disease (DKD). Methods: MeSH terms and free text searches were performed on MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception to April 2015. Zetoc and OpenGrey databases were queried for grey literature, and lastly, hand searches were carried out. Study selection and quality assessment were conducted by two authors. One author carried out data extraction, which was checked by other authors. The relationships between apneahypopnea index (AHI), oxygen desaturation index (ODI), time spent under 90% oxygen saturation (%TST < 90), and minimum and mean oxygen saturation (O2) on DKD were examined. Results: Two longitudinal and ten cross-sectional studies were included for our narrative synthesis, and seven studies for meta-analysis. Studies that performed multi-variable analysis demonstrated significant associations between OSA (assessed using either apnea-hypopnea index or ODI) and DKD in type 2 diabetes mellitus (T2DM). This was confirmed by meta-analysis (pooled OR 1.73, 95% CI: 1.13-2.64). There was some evidence to suggest that %TST < 90 may have an association with DKD. There was insufficient evidence to conclude on the relationship between minimum and mean oxygen saturation on DKD. There was no evidence available on the associations between OSA and other respiratory parameters in type 1 diabetes mellitus populations. Conclusions: There is moderate evidence that OSA is associated with DKD in patients with T2DM. Large prospective studies with long-term follow up are needed to assess the possible bi-directional mechanisms between OSA and DKD.
KW - Airway
KW - Albuminuria
KW - Apnea
KW - Creatinine
KW - Diabetes mellitus
KW - Glomerular filtration rate
KW - Nephropathy
KW - Nocturnal hypoxemia
UR - http://www.scopus.com/inward/record.url?scp=84957073799&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84957073799&partnerID=8YFLogxK
U2 - 10.5665/sleep.5432
DO - 10.5665/sleep.5432
M3 - Article
C2 - 26414891
AN - SCOPUS:84957073799
VL - 39
SP - 301
EP - 308
JO - Sleep
JF - Sleep
SN - 0161-8105
IS - 2
ER -